Step 3: Generate a Differential Diagnosis

Objective :

Use a Diagnostic Sieve to generate a differential diagnosis list

Diagnostic sieves are a valuable and efficient way of assessing a patient’s symptoms and signs to reach a diagnosis.

Click on the categories that are relevant to this case. Correct answers are highlighted in green.

Inflammatory /
Infection

This could be an early presentation of an inflammatory condition such as Juvenile Rheumatoid Arthritis.

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Neoplasm

The history of swelling and night pain, combined with the exam findings of a hard swelling just below the knee make a neoplasm a definite possibility.

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Traumatic

Although a stress fracture could possibly present like this, the swelling in the tibia makes it less likely.

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Endocrine

Some metabolic disorders can present with joint or bone pain.

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Next Step

Open ended questions establish which symptoms are most important to the patient and promote good rapport.